When can i ride my bike?

Hi everyone, i did try to do a search in the forums for an answer but i did not find anything specific or i dont know how to properly search. lol... anyway... had my PM installed on July 2, today is the 25th so just over 3 weeks ago. I have a dual chamber Medtronic something or other for bradycaria... i feel my healing process is going well, i still have a noticable lump where i was glued back up and it feels like dead skin, i am thinking this will go away with time so not too worried about that.. what i was wanting more information on was the overall healing process and when i can 'do things' again. My doctor is really good at what he does, but i dont get a ton of information from him, at least not to my expectations. I am very analytical and i like to know the ins and outs of everything. So with regard to healing, he says about 4-6 weeks then i can resume 'normal' things, and until then do not lift my (left) arm above my head or do any kind of heavy lifting or putting a lot of weight on it. At my 2 week FU he said i could drive again if i was careful not to spin the wheel with my left hand. My understanding is that the reason for this is i am waiting for the leads to 'mate' to my heart muscle... is this right? he says this can take up to 2 months, which is 8 weeks... i am OK with that, i just want to be sure i understand it. What i understand is i have 2 leads from my PM to he upper and lower chamber, and these leads are placed, but not fully attached.. now i am in the period of 4-8 weeks to allow the leads to fully mate with the tissue/muscle, and the reason for not reaching my arm over my head is becuase that movemment could pull the lead (or one of them) out of place, in which case they have to go back into surgery and replace it...  can anyone tell me if my understanding is correct so far? so assuming it is.. how long do you think i need to wait to be 110% safe and certian my leads are healed in and i can resume mowing the lawn, riding my bike, doing yard work and some other fun things? is 6 weeks good to go? 8 weeks safer? TIA i really appreciate it.... cheers!!


Healing process

by AgentX86 - 2020-07-25 13:07:31

Listen to your doctors before anyone on the Internet. If you're not happy with his answer, don't take the answer from anyone here as superseding his.

That disclaimer made, I'd wait to do any aggressive bike riding. Easy biking won't hurt anything but a fall may be very bad (the reason for the "aggressive" adjective above). Eight weeks is "out there". Four should be good for anything but a full golf swing or tennis, if the pacemaker is implanted in your dominant shoulder.

Bottom line: go easy for a while longer and slowly get back to normal life.

BTW, your doctor is being very conservative IMO. Unless you were/are at risk of syncope, a week is the normal driving ban. Two weeks for exercise enough to break a sweat, and four weeks for "normal" activities (with the golf and tennis restrictions above).

But, again, listen to your doctors. They may have good reason for their conservative approach in your case.

good advice

by wambajamba - 2020-07-25 13:27:07

thanks Agent86... solid advice....  i am just trying to gain a full understanding as is necessary for my brain to process and accept.... (thick skull).. lol....

Get on with your life

by crustyg - 2020-07-25 16:49:20

I agree with AgentX86 - your EP doc is being *very* conservative.

All modern leads are anchored with a small metal helix/screw that is screwed into the heart muscle, and over the next few weeks fibrous tissue grows around the lead and provides additional attachment.  The risks of pulling an actively fixed lead out of your heart is small - it depends a lot on how much slack your EP doc provided and how well the helix was screwed into the heart muscle.  Leads come in various fixed sizes and there's not much downside to selecting a lead a little longer than might be thought necessary.  Looking at *my* CXR, there's a ton of slack on both leads, no real chance of pulling a lead out by reaching above the shoulder.

Arguably there's a bigger risk of dislodging a lead due to normal heartbeat contractions - most new PM patients have a fairly low maxHR for the first 6weeks or so.  But I was out on my roadbike four days post implant (healthy heart + arteries, just SSS+CI) - not everyone is so simple.

At our age, 8weeks of enforced inactivity is not a great idea.

Unless you know that your heart is damaged or vulnerable, I'd advise you to start more exercise now.  And next time you see your EP doc, take a list of your questions with you, and with maximum charm, politely insist on having them *all* answered before you leave.  It's *your* heart, *your* life, *your* PM.  *YOU* have to live with the consequences, not your EP doc.  Knowledge really is power.


by Selwyn - 2020-07-26 13:24:02

Pedal biking is not going to pull out any lead. You can ride a bicycle whenever you feel up to it. I was riding my bicycle within the first week of receiving my PM. 

What is nice about cycling is the arms are kept in a low position in relation to the body, and hold a steady position on the handle bars. There is plenty of slack in the leads when correctly fitted. This position ensures that your PM wound is not under any strain. 

As far as I am aware, there is no relationship between arm position and leads becoming displaced. This is not suprising as fitting ensures that there is enough lead to enable to arm to  be raised upright without traction at the implant tip. 

I posted this March on this subject:

There is no correlation between arm position and lead displacement ( merely comfort). Do what is comfortable for you. 


 "We encourage the development of consistent discharge instructions that will promote early mobility and a safe and rapid return to normal activities. " I could not agree more!

2 random controlled trials have shown that early mobilization is safe and feasible, and some physicians encourage a full range of movement on the affected arm. Moreover, patients could self-restrict the arm movements and arm-related daily activities to a further degree or for a longer duration to avoid the risk of device malfunction or to decrease pain.  However, prolonged immobilization or restriction of the arm movements have been associated with the development of shoulder problems such as adhesive capsulitis etc.

Most of the lead displacement is due to bad contact in the first place with the heart muscle ( Don't forget this muscle is moving to and fro, with some force in order to pump your blood, sixty times or more per minute).

good infomation

by wambajamba - 2020-07-26 16:08:06

thank you crustyg and Selwyn, a lot of things i did not know, like how the leads are attached. That makes a lot of sense. I think with my lack of understanding in how the PM and leads are placed and the minimal information from my doctor about it all, leaves me in a position that i want to be as safe as i can. My doc said about 6 weeks for the biking, and i am coming up to 4 this thursday so i can probably manage to wait a few more weeks, or i can call back into the office and ask them if its OK. The good news is i have not been without a lack of excersize. While i have not been riding my bike, i have been doing plenty of walking. I have been walking around 10K steps per day since the 2nd day after my implant. I get my HR up to about 114 avg throughout. When i bike i normally get up to about 138... so i am getting excersise and i have been mowing the lawn with one arm last 2 saturdays... i just miss my morning bike rides and looking forward to getting back to them... i really appreciate the info about the lead placement. I guess i dont know for sure if mine are anchored with the helix fastner, but i can ask about that. And yes, i will be prepared with a list of questions when i go back in for my FU in October... thank you again for all the replies, it helps me learn more about this gizmo inside me.... have a good one!!


by AgentX86 - 2020-07-26 20:43:45

Walking is probably one of the best overall exercises.  My endocrinologist believes that it is, by a long shot.  It puts enough stress on the bones to help with osteoperosis and not so much stress on the joints. 

114bpm walking seems like a lot to me.  I walk a lot and other than when I'm on a treadmill at the gym at a very high angle, I never get over 100bpm and then it's about 110.  My resting rate is 80bpm, so walking doesn't get much of a rise out of my PM.  Of course that's set by RR, but I don't run out of "gas".  I'm tired after three hours but breathing normally.

Anyway, keep up the walking.  It's a great, if slow, exercise.  I restarted my walking the day after I was released from the hospital.  I made sure I didn't sweat but in February, that wasn't much of a problem.  ;-)

sweating it

by wambajamba - 2020-07-27 06:43:43

i dont understand the sweat part.... i seen in another reply to make sure to not break sweat but i dont understand the reasoning there.... my walks are done for excersize and i always sweat. We have a nice paved trail (former railroad track) by me and i walk intentionally at a brisk pace (about 4mph) and i dont profusely sweating, but i do sweat.... is that a bad thing? TIA

Sweating can dislodge the skin dressing and track infection into a partly healed wound

by crustyg - 2020-07-27 13:31:30

I think the logic here is twofold - sweat can undermine the adhesive properties of your wound dressing (there's an episode of the Simpsons where Bart gets his head stuck in a saucepan with superglue and the wily Doc prepares to inject a massive needle into him - Bart - to induce terror-sweat - to release the glue).  And secondly having a stream of sweat running over your skin and now potentially underneath the dressing is a potential source of infection.  Doesn't matter if the skin wound id 100% healed, of course.


sweating continued

by wambajamba - 2020-07-27 16:24:31

OK, that makes sense... well this thursday will be the 4 week point and my wound is looking good.. i was told i could take off the oiginal dressing/bandage at the 2 week mark and since my doc has allowed me to shower with a towel over my wound. So i think i am in the clear for all the concerns mentioned. They did have me on 10 days of antibiotics as well and that would thwart off infection i guess... regardless, i think i am AOK now and will sweat away!! thanks for the reply and informtion, i really do appreciate it more than you know.... peace out chuck

You know you're wired when...

You have a maintenance schedule just like your car.

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